Critical interpretation of urinary phencyclidine monitoring.

A critical appraisal of issues and problems in monitoring urinary phencyclidine (PCP) is presented. Problems may be related to impurities of ingested material and/or metabolites, and methods that are not sensitive enough to detect PCP in the nanogram/ml amounts which may be present in blood or urine. Possible false positives found with some methods are discussed. Most complicated of all is the unpredictable excretion of PCP which can result in negative urines followed by urines which test positive for PCP without necessity of any further ingestion of PCP. A set of guidelines for use in monitoring and interpreting PCP values is included.

Urinary acidifiers in phencyclidine detoxification.

Urinary acidification is widely used to increase the excretion rate of PCP in abusers. Various acidifying techniques were used and compared with regard to efficacy in lowering pH, side effects, and patient acceptability. On the basis of our findings and data from routine monitoring with test tapes, we would recommend the following acidifications procedures as efficacious and reasonably well tolerated: Ammonium chloride, 4 gm. per day, 1 gm. q.i.d., with sufficient water or cranberry juice. Lysine dihydrochloride, 6 gm. per day, 2 gm. t.i.d., with sufficient water or cranberry juice. Lysine hydrochloride, 8 gm. per day, 2 gm. q.i.d., with water or cranberry juice. Cranberry juice, 18 or more oz. per day alone, or plus lysine, ammonium chloride, or ascorbic acid.

Chronic phencyclidine abuse and physical assault.

When the authors investigated aggressive behavior on a phencyclidine (PCP) detoxification and rehabilitation unit and compared similar types of behavior on a heroin unit, they found no differences between the two units. The urinary PCP levels of a subgroup of 75 patients admitted to the PCP unit who had PCP-positive urine were significantly higher than those of 75 patients admitted to an acute psychiatric ward because of violent behavior who also had PCP-positive urine. The authors discuss the implications of these findings and the need for more information on the relationship between PCP levels in blood and urine and behavior.

Urinary phencyclidine excretion in chronic abusers.

Data on usage patterns of 100 hospitalized chronic phencyclidine abusers was collected. Weekly urine samples were monitored using a new gas chromatographic nitrogen detector analysis for PCP. Abusers were found to be, on the average, young males who had used PCP for approximately 40 months (range 12 to 96 months) and approximately 3 to 4 d/week. Except for one subject, urines became negative for PCP within 30 d after last use with a mean of 14 d. There was rapid excretion during the first 9 d followed by a more gradual reduction in urine PCP levels.

'Loads' alert.

"Loads," a combination of glutethimide and codeine, are a relatively new form of drug abuse that is increasing in popularity in the Los Angeles area as a heroin-substitute. Preliminary findings based on interviews and treatment of a group of preferential Loads abusers seen over a one-year period suggest that this combination has a potential for serious intoxications and withdrawal complications. The common withdrawal symptoms include those produced by both a sedative-hypnotic and a major narcotic and necessitate a detoxification plan based on the pharmacologic rationale of the abused combination.